SOFT TISSUE CALCIFICATIONS

Hatice Güller1
Muhammed Akif Sümbüllü2

1Atatürk University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Erzurum, Türkiye
2Atatürk University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Erzurum, Türkiye

Güller H, Sümbüllü MA. Soft Tissue Calcifications. In: Çakır B editor. Common Lesions of the Oral Cavity. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.21-30.

ABSTRACT

Soft tissue calcifications and ossifications in the craniofacial region, although rarely encountered, are often incidentally detected during routine radiographic examinations and may present clinically signif- icant findings. These calcifications and ossifications are generally classified into three main categories based on their etiology: dystrophic, idiopathic, and metastatic. Dystrophic calcifications typically arise following inflammation or tissue damage, leading to mineral deposition in the affected areas. Idiopath- ic calcifications, on the other hand, occur without any apparent underlying cause. Metastatic calcifica- tions result from the systemic spread of cancer within the body. Ossifications differ from calcifications in that they involve the process of bone formation and are associated with more specific anatomical structures. Examples of ossifications observed in the craniofacial region include stylohyoid ligament ossification, osteoma cutis, myositis ossificans, and Longus Colli tendinitis. While soft tissue calci- fications and ossifications are often asymptomatic, they may occasionally lead to significant clinical manifestations such as pain, swelling, restricted movement, and functional impairment. However, in the majority of cases, these lesions remain asymptomatic for extended periods and are identified inci- dentally during routine radiographic evaluations. The location, size, and morphology of these lesions are typically critical diagnostic criteria. Calcifications and ossifications in the craniofacial region are usually simple cases, but in certain instances, they may present as more complex and symptomatic conditions. Diagnosis and treatment planning should consider factors such as anatomical localization, distribution, number, size, and shape of the lesions.

This section classifies soft tissue calcifications and ossifications observed in the craniofacial region based on their general characteristics and discusses their clinical and radiographic features. Under- standing the distinctions between calcifications and ossifications is essential for accurate diagnosis and effective treatment planning.

Keywords: Calsinosis; Heterotopic ossification; Incidental findings; Oral patholoji; Panoramic radiography

Referanslar

  1. Syed AZ. Soft Tissue Calcifications in the Head and Neck Region. Dent Clin North Am. Apr 2024;68(2):375-391. [Crossref]  [PubMed]
  2. Özemre MÖ, Seçgin CK, Gülşahı A. Yumuşak doku kalsifikasyonları ve ossifikasyonları: derleme. Acta Odontologica Turcica. 2016;33(3):166-75. [Crossref]
  3. Khojastepour L, Haghnegahdar A, Sayar H. Prevalence of Soft Tissue Calcifications in CBCT Images of Mandibular Region. J Dent (Shiraz). Jun 2017;18(2):88-94.
  4. Garg AK, Chaudhary A, Tewari RK, Bariar LM, Agrawal N. Coincidental diagnosis of tuberculous lymphadenitis: a case report. Aust Dent J. Jun 2014;59(2):258-63. [Crossref]  [PubMed]  [PMC]
  5. Dai GC, Wang H, Ming Z, et al. Heterotopic mineralization (ossification or calcification) in aged musculoskeletal soft tissues: A new candidate marker for aging. Ageing Research Reviews. 2024;95:102215. [Crossref]  [PubMed]
  6. Harorlı A, Akgül H, Yılmaz A, Bilge OM,Dağistan S, Çakur B, et al. Ağız, diş ve çene radyolojisi. İstanbul: Nobel Tıp Kitabevleri. 2014;(s 176)
  7. Keberle M, Robinson S. Physiologic and pathologic calcifications and ossifications in the face and neck. European radiology. 2007;17(8):2103-11. [Crossref]  [PubMed]
  8. Wyman SM, Weber AL. Calcification in intrathoracic nodes in Hodgkin's disease. Radiology. 1969;93(5):1021-1024. [Crossref]  [PubMed]
  9. Garg A, Chaudhary A, Tewari R, Bariar L, Agrawal N. Coincidental diagnosis of tuberculous lymphadenitis: a case report. Australian Dental Journal. 2014;59(2):258-263. [Crossref]  [PubMed]
  10. Mandel L. Multiple bilateral tonsilloliths: case report. Journal of oral and maxillofacial surgery. 2008;66(1):148-150. [Crossref]  [PubMed]
  11. Takahashi A, Sugawara C, Kudoh T, et al. Prevalence and imaging characteristics of palatine tonsilloliths detected by CT in 2,873 consecutive patients. The scientific world journal. 2014;2014(1):940960. [Crossref]  [PubMed]  [PMC]
  12. Kumar BD, Dave B, Meghana SM. Cysticercosis of masseter. Indian J Dent Res. Jul-Aug 2011;22(4):617. [Crossref]  [PubMed]
  13. Avsever H, Orhan K. Çene kemiği ve çevre dokuları etkileyen kalsifikasyonlar. Turkiye Klinikleri J Oral Maxillofac Radiol-Special Topics. 2018;4(1):43-52.
  14. Erol İ, KayZ, Serdaroğlu A. Nörosistiserkozis: Bir Olgu Sunumu. Turkiye Klinikleri Journal of Pediatrics. 2004;13(1):40-43.
  15. Kamikawa RS, Pereira MF, Fernandes Â, Meurer MI. Study of the localization of radiopacities similar to calcified carotid atheroma by means of panoramic radiography. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2006;101(3):374-378. [Crossref]  [PubMed]
  16. Bar T, Zagury A, London D, Shacham R, Nahlieli O. Calcifications simulating sialolithiasis of the major salivary glands. Dentomaxillofacial Radiology. 2007;36(1):59-62. [Crossref]  [PubMed]
  17. Cannon P, Bhatti D, Arman S, Togo A. Submandibular sialolith migration. BMJ Case Rep. 2023:22;16(5):e252482. [Crossref]  [PubMed]
  18. Bar T, Zagury A, London D, Shacham R, Nahlieli O. Calcifications simulating sialolithiasis of the major salivary glands. Dentomaxillofacial Radiology. 2007;36(1):59-62 [Crossref]  [PubMed]
  19. Yıldırım D, Bilgir E. Baş Boyun Bölgesindeki Yumuşak Doku Kalsifikasyon ve Ossifikasyonlari. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2015;25(13) [Crossref]
  20. Ajmani M, Jain S, Saxena S. A metrical study of laryngeal cartilages and their ossification. Anatomischer Anzeiger. 1980;148(1):42-48.
  21. O'bannon R, OH G. The larynx and pharynx radiologically considered. Southern medical journal. 1954;47(4):310-316. [Crossref]  [PubMed]
  22. Bamgbose BO, Ruprecht A, Hellstein J, Timmons S, Qian F. The prevalence of tonsilloliths and other soft tissue calcifications in patients attending oral and maxillofacial radiology clinic of the university of iowa. International Scholarly Research Notices. 2014;2014(1):839635. [Crossref]  [PubMed]  [PMC]
  23. Aydin U, Hastar E, Yildirim D. Dacryolith: two case reports. Dentomaxillofacial Radiology. 2007;36(4):237-239. [Crossref]  [PubMed]
  24. Bayramov N, Öztürk AÜ, Yalçinkaya ŞE. Incidental Soft Tissue Calcifications in Cone-Beam Computed Tomography Images: A Retrospective Study. Turkiye Klinikleri Journal of Dental Sciences. 2022;28(2) [Crossref]
  25. Gokce C, Sisman Y, Sipahioglu M. Styloid process elongation or eagle's syndrome: is there any role for ectopic calcification? European journal of dentistry. 2008;2(03):224-228. [Crossref]  [PubMed]  [PMC]
  26. Badhey A, Jategaonkar A, Kovacs AJA, et al. Eagle syndrome: a comprehensive review. Clinical neurology and neurosurgery. 2017;159:34-38. [Crossref]  [PubMed]
  27. Raina D, Gothi R, Rajan S. Eagle syndrome. Indian Journal of Radiology and Imaging. 2009;19(02):107-108. [Crossref]  [PubMed]  [PMC]
  28. Safi Y, Valizadeh S, Vasegh S, Aghdasi MM, Shamloo N, Azizi Z. Prevalence of osteoma cutis in the maxillofacial region and classification of its radiographic pattern in cone beam CT. Dermatology Online Journal. 2016;22(1). [Crossref]  [PubMed]
  29. Cottoni F, Dell'Orbo C, Quacci D, Tedde G. Primary osteoma cutis. The American journal of dermatopathology. 1993;15(1):77-81. [Crossref]  [PubMed]
  30. Niebel D, Poortinga S, Wenzel J. Osteoma cutis and calcinosis cutis:"Similar but different". The Journal of Clinical and Aesthetic Dermatology. 2020;13(11):28.
  31. Baginski DJ, Arpey CJ. Management of multiple miliary osteoma cutis. Dermatologic surgery. 1999;25(3):233-235. [Crossref]  [PubMed]
  32. Boffano P, Zavattero E, Bosco G, Berrone S. Myositis ossificans of the left medial pterygoid muscle: case report and review of the literature of myositis ossificans of masticatory muscles. Craniomaxillofacial trauma & reconstruction. 2014;7(1):43-50. [Crossref]  [PubMed]  [PMC]
  33. Jiang Q, Chen MJ, Yang C, et al. Post-infectious myositis ossificans in medial, lateral pterygoid muscles: A case report and review of the literature. Oncology letters. 2015;9(2):920-926. [Crossref]  [PubMed]  [PMC]
  34. Sarac S, Sennaroglu L, Hosal A, Sozeri B. Myositis ossificans in the neck. European archives of oto-rhino-laryngology. 1999;256(4):199-201. [Crossref]  [PubMed]
  35. Singleton EB, Holt JF. Myositis ossificans progressiva. Radiology. 1954;62(1):47-54. [Crossref]  [PubMed]
  36. Shawky A, Elnady B, El-Morshidy E, Gad W, Ezzati A. Longus colli tendinitis. A review of literature and case series. Sicot j. 2017;3:48. [Crossref]  [PubMed]  [PMC]